Surgical endoscopy
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Median arcuate ligament syndrome is a rare disorder resulting from luminal narrowing of the celiac artery by the insertion of the diaphragmatic muscle fibers or fibrous bands of the celiac nervous plexus. The syndrome is characterized by weight loss, postprandial abdominal pain, nausea, vomiting, and an epigastric bruit. Surgical management entails complete division of the median arcuate ligament. ⋯ The patient was discharged on postoperative day 3 and remained asymptomatic after 7 months of follow-up. Laparoscopic release of the median arcuate ligament is a novel approach to the management of celiac artery compression syndrome. The role of minimally invasive techniques to manage median arcuate ligament syndrome is evolving but they appear to be a safe alternative to open surgery.
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The laparoscopic approach promises to become the gold standard for the transabdominal management of full-thickness rectal prolapse. The aim of this study was to review our experience and to highlight the functional results achieved with this new technique. ⋯ Laparoscopic rectopexy with or without resection is both safe and effective. Advantages include low-morbidity, improved cosmesis, the rapid return of intestinal function, early discharge from hospital, and a low recurrence rate. The fecal continence score is improved; however, constipation is frequently worsened.
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Pneumoperitoneum has been associated with a decreased flow in the superior mesenteric artery and portal venous system. Intestinal blood flow was studied during a 2-h pneumoperitoneum with carbon dioxide (CO2) or helium in a porcine model using colored microspheres. ⋯ Intestinal perfusion does not change significantly during prolonged pneumoperitoneum at a pressure of 15 mmHg with CO2 or helium.
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Comparative Study
The impact of a laparoscopic colorectal surgeon on the laparoscopic colectomy experience of a single academic center.
The objective of this study was to evaluate the impact of a laparoscopic colorectal surgeon (LCRS) on the laparoscopic colectomy experience of a single academic center. ⋯ The addition of an LCRS had a significant impact on this center's experience with laparoscopic colectomies in terms of both volume and case complexity.
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Randomized Controlled Trial Comparative Study
Preoperative and postoperative levels of interleukin-6 in patients with acute appendicitis: comparison between open and laparoscopic appendectomy.
Cytokine interleukin-6 (IL-6) is an early marker of systemic inflammatory response and tissue damage. This study aimed to evaluate the levels of IL-6 after open and laparoscopic appendectomy to compare the degree of surgical stress associated with these procedures. ⋯ The operative stress in open as compared with laparoscopic appendectomy is not reflected by circulating levels of IL-6.